Medicine and Health Sciences Commons^™

Cannabinoid Modulation Of Chemotaxis Of Macrophages And Macrophage-Like Cells, Erinn Shenee Raborn

Theses and Dissertations

Exogenous and endogenous cannabinoids have been reported to modulate functional activities of macrophages. It is recognized that macrophages express primarily the CB2 cannabinoid receptor, but recent studies indicate that its expression is differential in relation to activation state with maximal levels occurring when cells are in "responsive" and "primed" states. The functional activities of macrophages when in these states of activation are the most susceptible to the action of cannabinoids, at least in terms of a functional linkage to the CB2. To assess the effect of cannabinoid treatment on macrophage chemotaxis and test the hypothesis that cannabinoids inhibit the chemotactic …

Interactions Of Mtfabh With Its Substrates And Inhibitors Reveal Novel Mechanistic Insights, Sarbjot Singh Sachdeva

Theses and Dissertations

Tuberculosis emerged from its grave to be one of the deadliest diseases of the present time after recently developing a synergy with AIDS. A fatty acid condensing enzyme-mtFabH has been proposed to connect the key processes involved in biosynthesis of mycolic acids, an important component of mycobacterial cell wall. It condenses long acyl Coenzymes A (CoA; up to C20CoA) with malonyl Acyl Carrier Protein (ACP) to form the elongated β-ketoacyl-ACP which further undergoes rounds of elongation to form mero-mycolate branch of mature mycolic acids. Owing to its proposed central position in mycolic acid synthesis, mtFabH has attracted considerable attention as …

Vocational Rehabilitation Of Clients With Brain Injury: An Investigation Of Racial Disparity Within The Rehabilitation Services Administration (Rsa) 911 Database, Stephanie A. Kolakowsky-Hayner

Theses and Dissertations

Finding and maintaining employment is an ongoing problem for persons with disabilities, especially those with brain injuries. State vocational rehabilitation agencies are the primary authority responsible for providing employment-related services for individuals with disabilities throughout the United States. Little effort has been committed to identifying disparities in health and rehabilitation services provided to Americans with disabilities, particularly those with brain injuries. The purpose of this investigation was to utilize Aday and Andersen's Framework for the Study of Access to examine racial disparity within the Rehabilitation Services Administration 911 Database, and thus the vocational rehabilitation system, among clients with brain injury. …

An Examination Of The Relationships Among Health Literacy, Social Support, And Patient Activation In Community Residing Older Adults, Brenda L. Harding Hage

Theses and Dissertations

This study examined the relationships among the variables health literacy, social support, and patient activation. The subjects were 90 elderly, community residing adults meeting the inclusion criteria and who volunteered to participate in the study and completed three survey instruments: the Short Form of Functional Health Literacy (Parker, Baker, Williams & Nurss, 1995); the Medical Outcomes Survey (MOS) Social Support Survey Instrument (Sherboume & Stewart, 1991); the Patient Activation Measure (PAM) Short-Form (Hibbard, Mahoney, Stockard, & Tusler, 2005); and a demographic form.

A correlational design was used to test the hypotheses that social support and health literacy are positively related …

Stress And Anxiety In Adhd: Links To Sensory Over-Responsivity, Stacey E. Reynolds

Theses and Dissertations

Sensory Modulation Dysfunction (SMD) is characterized by an inability to consistently and accurately grade responses to sensory information. SMD, and specifically sensory over-responsivity (SOR), has been correlated with stress and anxiety in some developmentally delayed populations and has been associated with structures and functions of the hypothalamic-pituitary adrenal (HPA) axis. Recent attention has been given to HPA functioning in children with Attention Deficit Hyperactivity Disorder (ADHD), with a majority of studies identifying blunted or diminished cortisol patterns. In contrast, elevated cortisol has been associated with anxiety and anxious behaviors in both animal and human studies. The purpose of this study …

Determinants Of Obesity: Racial Differences, Nikkia L. Goforth

Theses and Dissertations

BACKGROUND: Obesity is a major public health problem. Studies have shown that there are racial and ethnic differences in the prevalence of obesity. However, there is limited research that examines the effects of sedentary and poor lifestyle behaviors and obesity among different racial and ethnic groups. Furthermore, most studies focus on the problem of obesity among children. This study was conducted to examine racial differences in determinants of obesity in adults in the United States. METHODS: Data from the 2005 Behavioral Risk Factor Surveillance System was used for this analysis. Demographics, lifestyle behaviors, and existence of chronic diseases were assessed. …

Supporting Personhood In Dementia: Examining The Impact Of Volition On Function In Everyday Occupations, Christine L. Raber

Theses and Dissertations

Understanding volition and preferences for occupation is a critical underpinning of effective occupational therapy services that promote and preserve identity for persons with moderate dementia. Although it has been posited that this population has significant difficulty expressing volition for daily occupations, little research has examined the role of volition in guiding engagement in occupations. This phenomenological study provides an in-depth description and analysis of volition in eight persons with moderate dementia. Guiding questions related to understanding patterns of past life interests, outward demonstration of volition, volitional continuity. and the relationship of the social environment to volition and engagement in daily …

Transition From Health Maintenance Organizations To Consumer Driven Health Plans: Measurement Of Initial Impacts For Members With Chronic Conditions, Carl F. Goff

Theses and Dissertations

New consumer driven health insurance products are designed to contain health care costs by making consumers more accountable for the care they receive through being responsible for more cost sharing, making decisions regarding health care providers they will use, and increasing exposure to and use of health information for services and providers. Potential benefits of consumer driven products include increased information regarding personal health and a more knowledgeable patient base. Potential drawbacks of consumer driven products include negative impacts on consumers with chronic and complex health conditions.

The purpose of this study was to ascertain differences in health services utilization …

On The Binding Of N1-Substituted Tryptamines At H5-Ht6 Receptors, Abner Nyamwaro Nyandege

Theses and Dissertations

Serotonin was first discovered in the late 1940s as a vasotonic factor and is now considered a principal neurotransmitter in the nervous system. 5-HT6 receptors are one of the most recently identified members of the serotonin receptor family which consists of seven classes (5-HT1-5-HT7). 5-HT6 receptors are G-protein coupled, positively coupled to an adenylate cyclase second messenger system and are primarily found in the central nervous system (CNS). The exact functional role of 5-HT6 receptors has not been determined, but is implicated to have possible involvement in certain neuropsychiatric disorders and cognition. To investigate the functional role of these receptors, …

Adverse Anesthesia Outcomes: A Retrospective Study Of An Ambulatory Surgical Center Versus A Dental Office Setting, Gaurav Agarwal

Theses and Dissertations

Purpose: The purpose of this study was to compare the adverse events that occur with general anesthesia for dental rehabilitation between a hospital setting and dental clinic setting. Methods: A retrospective chart review was performed examining patients who had received dental rehabilitation with general anesthesia at the Virginia Commonwealth University Department of Pediatric Dentistry. Subjects were either treated in the Pediatric Dental Clinic or the Hospital Ambulatory Surgery Center (ASC) from July 2005 to December 2006. Anesthesia records of induction, intubation, maintenance, emergence and recovery were compared between the two settings.Results: There were a total of 422 charts reviewed with …

Analgesic Use In U.S. Emergency Departments For Patients Reporting Moderate To Severe Pain: Diagnosis And Select Patient Characteristics Influencing Narcotic Analgesic Prescribing Practices, Hassan Zakaria

Theses and Dissertations

Objective: This study aims to examine the relationship between emergency department patient encounter characteristics and narcotic analgesic prescribing practices in order to determine what patient characteristics, if any, influence the decision to prescribe narcotics.Methods: Cross sectional data on patients presenting to U.S. emergency departments from the 2003 and 2004 National Hospital Ambulatory Medical Care Survey were analyzed. Patients reporting moderate to severe pain were included in the sample and analysis. Chi square tests of significance were used to assess the association between individual demographic and encounter characteristics to narcotic prescription or administration. Separate multiple logistic regressions were then performed on …

Characterization Of The Factors Associated With Sccmec Mobility In Staphylococcus Aureus, Michael James Noto

Theses and Dissertations

The gene encoding resistance to β-lactam antibiotics in the staphylococci is found on the chromosome in a genomic island designated Staphylococcal Chromosome Cassette mec or SCCmec. In addition to the resistance gene, mecA, SCCmec also contains site specific recombinase genes, ccrAB, that are capable of catalyzing the chromosomal excision and integration of SCCmec. The increasing prevalence of methicillin-resistant Staphylococcus aureus infections may be due, in part, to the transfer of SCCmec into successful methicillin-sensitive S. aureus lineages. In this work we attempt to better characterize the factors associated with SCCmec transfer, beginning with CcrAB-mediated SCCmec excision in a collection of …

Improving Life Satisfaction Of Elders Through Oral History: The Narrator's Perspective, Mary B. Ligon

Theses and Dissertations

Oral history is a method of preserving historical information through in-depth interviews. Because the process requires narrators to use remote recall while sharing their life experiences, it can also be considered a reminiscence-related activity. Before this study, the positive effects on narrators of providing an oral history were noted in the research literature but had not been evaluated through quantitative methods. Based on theoretical constructs of Erikson and Butler, it was hypothesized that participation in oral history interviews would improve the life satisfaction of narrators. Life satisfaction was operationalized and measured using the Life Satisfaction Index Version A (LSIA). The …

Sodium Hypochlorite's Effect On Nickel-Titanium Rotary Instruments And Its Effect On Resistance To Fracture, Michael Shane Smith

Theses and Dissertations

The purpose of this study was to examine the effect of partial and total immersion in sodium hypochlorite on nickel-titanium rotary files and to determine whether resistance to fracture was influenced by the immersion time. One hundred K3™ and 100 ProFile® rotary files were either partially or totally immersed in 5.25% sodium hypochlorite for zero, one, five, thirty, or sixty minutes. After immersion, files were subjected to cyclic fatigue testing. Time to fracture was recorded and analyzed by a two-way ANOVA. Tukey's honest significant difference was used to identify any differences in immersion times. Within all ProFile groups and partial …

Impact Of Combat Stress On Mental Health Outcomes: Brfss Survey Data 2006, Emily Pedneau

Theses and Dissertations

Objectives: This study sought to determine the relationship between combat experience and mental health outcomes. The study sought to determine whether age was a significant factor in poor mental health outcomes. Methods: Multiple logistic regression (n = 195,048) and multiple linear regression (n = 264,154) were performed on the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey. Veteran status and a host of demographic and health status questions were analyzed in relation to diagnosis of anxiety or depressive disorder (multiple logistic regression) and to number of days poor mental health (multiple linear regression). Results: Diagnosis of anxiety or depression was …

Trend Analysis Of Automobile Collision Amongst 15-19 Year Olds In Virginia, 2000-2004, Imo F. Ndem

Theses and Dissertations

Purpose. This research study on automobile collision in Virginia amongst fifteen to nineteen (15-19) year olds looked into the trend analysis over a five (5) year period of 2000 to 2004. Trend analysis is usually done for aggregates of all injuries—either intentional or unintentional injuries, or both. The primary objective of this research study was to examine the trend in hospitalization rates and mortality rates for males and females independently. It further looked into the trend, if any, in hospitalization rates, mortality rates, and case-fatality rates, for both males and females combined. The different Tables illustrate the extent and the …

Immunohistochemical Study Of Phenotypes Of Dendritic Cells In Dental Pulps From Non-Carious And Carious Teeth, Melissa A. Harmon

Theses and Dissertations

Mature dendritic cells (DCs) in inflamed tissues may promote inflammation but the status of DCs in pulpitis is not known. We hypothesized that DC maturation would correlate with carious lesion depth and that CD4+ cells would be found in association with mature DCs. Pulps were collected from teeth exhibiting: (I) no caries (n=9), (II) shallow dentinal caries (n=5), and (III) deep caries (n=9). Pulpal tissues were cryo-sectioned and positive cells were examined with immunohistochemistry, Mature DCs (CD83+) were almost exclusively restricted to pulps from deep caries. Furthermore, CD209+ DCs in deep caries were elevated over other groups and CD209+ cells …

Examination Of Birth Outcomes With Mode Of Delivery For Breech Presentation, Kelly Marie Arey

Theses and Dissertations

Introduction: Approximately 3% to 4% of all pregnancies at term will have a fetus with a breech presentation. Studies have shown that the US has almost completely abandoned vaginal delivery for breech presentation through the influence of the "Term Breech Trial" (TBT) which concluded that a policy of planned caesarian section would reduce perinatal mortality, late neonatal mortality, and serious neonatal morbidity by approximately two-thirds for term fetuses. However, the recommendations are still being challenged by others.Objectives: The purpose of the study was to describe who in Virginia is having a vaginal delivery for a breech presentation and to determine …

An Invitro Leakage And Viscosity Analysis Of Root End Filling Materials, Paul D. Clark

Theses and Dissertations

The purpose of this study was to determine if the viscosity of MTA Angelus Fluid is lower than that of Pro Root MTA and MTA Angelus; and to compare the viscosity, leakage and particle size of these materials to determine whether a relationship exists between these properties. The viscosity of each material was measured and compared with the Student's t test. MTA Angelus Fluid's viscosity was significantly lower than the other two materials tested. Microleakage of root end fillings was assessed in a passive diffusion model. Leakage groups were compared with a one-way ANOVA (p < 0.05). No significant difference was found. Particle size and shape were evaluated with the SEM. MTA Angelus Fluid has a lower viscosity than the other materials tested. There was no significant difference in the sealing ability of the three materials tested and there was no apparent variation in each material's particle size or shape.

Children With Special Needs Oral Health Quality Of Life Survey, Kristin Elizabeth Nelson

Theses and Dissertations

Purpose: The purpose of this study was to asses the oral health quality of life of children with special health care needs. This study examined the effects of oral health conditions on general well-being and family life of these children. A secondary aim of the study was to investigate correlations between specific health care conditions, gender, and age of these children and their global ratings of oral health and well-being.Methods: This study was a cross-sectional design with subjects who are members of the Virginia Care Connection for Children program, based at Virginia Commonwealth University. The oral health quality of life …

The Role Of Inhibitory Interneurons In A Model Od Developmental Epilepsy, Patrick James Wolfgang

Theses and Dissertations

Epilepsy, defined by recurrent seizures, is the one of the most prevalent neurological disorders worldwide (World Health Organization 2007). While many forms of epilepsy are well-controlled by anti-epileptogenic medications, a significant portion of patients have intractable, i.e. untreatable, seizures. The etiology of these seizures is varied, but a significant cause, particularly for patients with intractable epilepsy is developmental malformation. In these cases, an error or interruption during the development of the neocortex produces a structural alteration. Such patients may have other neurological problems, but seizures are the most common symptom. The neuronal mechanisms that link malformation and cortical hyperexcitability are …

The Effect Of Income Level On The Relationship Between The Personal Support Matrix And Sustained Breastfeeding, Sandra Mann Gossler

Theses and Dissertations

The Healthy People 2010 Objectives for the population of the United States include the objective for women to sustain breastfeeding at a higher rate than they are currently.The American Academy of Pediatrics (AAP) now recommends that all infants be fed human milk for the first year of life instead of the previously recommended first six months of life. Breastfeeding initiation rates are rising, but breastfeeding duration rates continue to fall. It was hypothesized that the support system of the women may play a role in the duration of breastfeeding. The purpose of this research study was to investigate the support …

A Comparision Of Delta-9-Tetrahydrocannabinol Dependence In C57bl/6j Mice And Fatty Acid Amide Hydrolase Knock Out Mice, Brittany Leigh Alice Carlson

Theses and Dissertations

The idea that humans and laboratory animals can become physically dependent on marijuana or its primary psychoactive constituent, delta-9-tetrahydrocannabinol (THC), is gaining acceptance. However, there are no currently approved pharmacotherapies to treat cannabinoid withdrawal. The objective of this thesis was to evaluate whether elevating endogenous anandamide levels using mice lacking fatty acid amide hydrolase (FAAH), the enzyme responsible for anandamide metabolism, would ameliorate THC dependence. Mice were treated subchronically with a low or high THC dosing regimen and challenged with the CB1 receptor antagonist, rimonabant, to precipitate withdrawal. Following subchronic THC treatment, rimonabant precipitated a significant increase in paw flutters …

Oral Health Services In A Medical Setting, Robert William Mansman Ii

Theses and Dissertations

Purpose: The purpose of this study is to examine the baseline oral health status of infants and the level of their caregiver's oral health knowledge for families who received preventive oral health services in a medical setting. Methods: Using a prospective cohort study, children 0-3 years of age received an oral health screening, risk assessment, caregiver education, and a fluoride varnish treatment in an ambulatory pediatric medical clinic. A 16-item oral health knowledge and socio-demographic questionnaire was delivered to the caregiver of child. This questionnaire included knowledge, behavior and opinion items on risk factors for dental diseases, care of child's …

Has Richmond, Virginia Become Safer In The Past Five Years (2002-2006)?: An Analysis Of Ambulance Data Regarding Penetrating Trauma Incidents, Ashleigh K. Mccabe

Theses and Dissertations

Introduction: The World Health Assembly declared violence as a worldwide public health problem. Homicides have been identified as a leading cause of death in the United States across all age groups. The national homicide rate for 2004 and 2005 are 5.5 and 5.6 per 100,000 population, respectively. The reported rates for Virginia are 5.2 (2004) and 5.6 (2005) per 100,000 population, showing a 16.9% increase. Richmond has been ranked as high as the sixth most dangerous among similar cities in the United States. This study examines penetrating trauma injuries identified through 9-1-1 calls as an indicator of the incidence of …

Analysis Of Mouse Eklf/Klf2 E9.5 Double Knockout: Yolk Sac Morphology And Embryonic Erythroid Maturation, Tina Kathy Lung

Theses and Dissertations

Krüppel-like factors (KLFs) are a family of transcription factors with 3 Cys2/His2 zinc fingers that regulate cell differentiation and developmental processes. EKLF is involved in primitive and definitive erythropoiesis; KLF2 is implicated in the development of primitive erythroid and endothelial cells of the vasculature. Using light and electron microscopy, the yolk sacs and dorsal aortae from EKLF/KLF2 double knockout (KO) E9.5 (embryonic day 9.5) were examined to determine whether these KLFs have compensatory functions in morphology of blood cells and vessels. EKLF/KLF2 double KO E9.5 erythroid, endothelial, and mesothelial cells had more severely abnormal morphology than WT and KLF2-/-. Flow …

Breast And Cervical Cancer Screening In Virginia: The Impact Of Insurance Coverage And The Every Woman's Life Screening Program, Kamila Somayaji

Theses and Dissertations

Background: Screening for breast and cervical cancers is important because early detection increases cancer survival. Since 1991, the U.S. government has helped finance a national early detection program for breast and cervical cancer among uninsured low-income women, known in Virginia (VA) as Every Woman's Life (EWL).Objectives: This study aims to determine whether there are differences in the prevalence of breast and cervical cancer screening based on insurance coverage, assess the prevalence of screening by health district, and evaluate the ability of EWL to effectively reach its target population.Methods: Cross-sectional data from the 2005 Behavioral Risk Factor Surveillance System survey were …

The Relapsing Fever Spirochete, Borrelia Hermsii, And Complement Regulatory Proteins, Kelley M. Hovis

Theses and Dissertations

Borrelia hermsii, the primary etiological agent of tick-borne relapsing fever in North America, binds the complement regulatory protein factor H (FH) as a means of evading opsonophagocytosis and the alternative pathway of complement. The sequence of the gene encoding the FH-binding protein has been determined. The protein is unique to B. hermsii and has been designated FhbA. Analyses of B. hermsii isolates revealed that FhbA is expressed by 24 of the 25 isolates tested. fhbA was demonstrated to be a single genetic locus through pulsed-field gel electrophoresis, restriction digest, and hybridization analyses, and all isolates possessing fhbA carry it on …

The Association Between Adult Self-Reported Asthma & Potential Exposures To Asthma Triggers In Virginia Workplaces: An Ecological Study, Jeanette R. Bowman

Theses and Dissertations

Introduction: Work-related asthma (WRA) is thought to be the most common occupational lung disease in the U.S., but there is no standard case definition of WRA. Most states, including Virginia, do not require WRA diagnoses to be reported to health departments. At present, there is too little epidemiological data on WRA in Virginia to direct public health planning efforts. Objectives: The first objective of this study was to estimate potential exposure to workplace asthma triggers in each of Virginia's 35 health districts. The second objective was to examine associations at the health district level between workplace asthma triggers, other asthma …

Relationship Between Facial Attractiveness And Occlusal Treatment Outcomes: A Retrospective Study, Chad Eric Fowler

Theses and Dissertations

The goal of this study was to determine if a relationship exists between pretreatment facial attractiveness and posttreatment occlusal outcome in orthodontic patients. A randomized sample of forty-seven patients (26 males, 21 females) was selected for inclusion in this study. Orthodontic evaluators rated pretreatment patient photographs (frontal smile, frontal, profile) using a 100 mm visual analog scale (VAS). Occlusal outomes were evaluated using percentage reduction in weighted Peer Assessment Rating (PAR) index scores and the American Board of Orthodontics objective grading system (ABO-OGS). Spearman correlation coefficients were calculated to assess the relationship between pretreatment VAS attractiveness ratings and posttreatment occlusal …